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B-2016-2784 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-2784 8123 PARK VILLA CIR CUPERTINO,CA 95014-4045(356 10 057) T F F HEATING AND AIR CONDITIONING MILPITAS,CA 95035 OWNER'S NAME: LEE I-TING ET AL DATE ISSUED:09/22/2016 OWNER'S PHONE:408-718-7281 PHONE NO:(408)500-9245 LICENSED CONTRACTOR'S TOR' DECLARATION BUILDING PERMIT INFO: License Class C-20 Lie.# 19 7350 Contractor T F F HEATING AND AIR CONDITIONING Date 06/30/2018 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X MECH X RESIDENTIAL_COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect.. JOB DESCRIPTION: REPLACE FURNACE(SAME LOCATION) I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the "performance of the work for which this permit is issued. rr I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1950.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 35610 057 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. (",Signature 1 Issued by:Abby Ay Date:09/22/2016 DECL ION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Scc.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/22/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall , be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:;3L22/2016 I certify that I have read this application and state that the above information is correct.i agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 9/22/2016 Professional GENERAL PERMIT APPLICATION MEP �._ COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUP R "IN0 (408)777-3228•FAX(408)777-3333-buildingQcuper ino.org misc PLUMBING MECHANICAL ELECTRICAL MISCELLANEOUS PROSECT ADDRESS g APN#12.3 f)&.- k V'i 1 t a C i r 25-6 - /D OSS OWNERNAME Ltp I1 J 11. U Crkf VZ PHONE q013 3-03 2�( EMAII..(�U IIA -C.CJy�r�� fLlll. STREET ADDRESS1 /f'!/a I`�f CITY,STATE,ZIP FAX 8[ti3 1�c��(e V (� 1'ti.o CA 91'';'014 CONTACT NAME PHONE <l If E-MAIL `k STREETADDRESSV l 1. CITY,STATE,Z11- l/ FAX OWNER ❑ OWNER-BUILDER. ❑ OWNERAGENT ❑ CONTRACTOR 14ONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME'T `f r��r�`��_ LICENSE NUMBER q (+I,� LICENSE TYPE �_� BUS.LIC# � � : �g . . COMPANY NAME ����++ 'lT/� E_MAII. Lel+!- /� f F HVA A G -TF-T hVA C `� . s,-k O o e FAX STREET ADDRESS CITY,STATE,ZIP /0 3 f Nc Vie, 'j C•4 gSo 2a PHONE ` j8 Sud t2y ARCHITECUENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF WFD.,DUPLEX 0 MULTI-FAMILY PROJECT IN WILDLAND '❑ YES PROJECTIN ❑.YES ISTHEBLDGAN ❑YES BUILDING. Q COMMERCIAL - URBAN INTERFACE AREA NO FLOOD ZONE ❑NO EICHLERHOME7 ❑NO DESCRIPTION OF WORK "at aU -?X) 13TH TOTAL VALUATION: ® RECEIVEIJB By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property o er's beh . I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the abovedcntifiedrroperty for inspection purposes. Signature of ApplicantlAgent: Date: SUPPLEMENTAL INFORMATION REQUIRED u � 1 r Q ST7Yi2Il z �3 LAitG�, vPI MEPMiscApp 2011.doc revised 06121111 S�1TATEOFgCALIFpORNLiIAS ray f AC CEGCF1R-Ati-03-E(P.eAsed 055) CA(_IFORNIA ENERGY COMMISSION CERTIFICATE OF COMPUANCE CFlR-Ali-03-E Alterations-HVAC Q 1,3 to 7--and 16{formerly CF2R-ALT-HVAC) (Page 10,`1) Site Address: EnforramentAgencIr Date Prepared_'' Permts i 3 ask Vt ►la Cr c '-6no New:.Ducting,Plenums,Line_ser ( Conditioned EquipmeritTYpe .Equipment EftraencY l ThermostatRequired R-value F}oorArea(salt) Q Packaged System II Evaporator Coil AFUE COP 0 R-6 (Q 1,3-71 Ducts Served by sysmm ILSetback ❑-R-8' ( )Ducts - 2aU pfriotalready 11 Split System D Condensing Unit SEER CZ?6Dsq ft-�--- resent must HSPF 0 R-5(all M)Plenums p Furnace L7 Ltneset _ EER - (]R-S or R7.5 Linesee be instanedj ! I4EFS' VERIFICATION SUMMARY Installer detamines work to be completed and matches to one ofthe options below At permit app}i'ral on this form Is allowed to be riled out by hand,Farfinal inspection all forms are to be registered(no hand filled fan ns allowed}and a copy left,an sit-- El rt-CI 1.HVAC ChangeoutjRepair Raquired'Compliance,Document;to fie left on sitaior Final= [an include new ducting s I All Equipment, CE?R-ALT-OZ-E Condenser Unit,Evaporator Co}l, CFZR--MKii-01,MECH 20-HERS Air CF3R:Iv1EtH-2t3-HERS i j .Installer Requirement:Duct leakage X35%or,<IO a to outside;or seal all accessible leaks) 3 Exempt--d from duct lealmga to aft if: l 1.Duct system registered with HERS provider as previously sealed,or 12 2-There is less than 40 linear feet ofductin unconditioned space,or W3.&xisting ductsysterns are constructed,insulated orsealed with asbasiQs:(lcstmanuiacture datz_of building ). Q 2.New HVAC System Regtfu-ed Compliance Documentsto be left on sate for Final: i l All new equipment and All New Ducts CF1R-ALP-42-E CRR-MECH-03,MECH 20-HERS,MECH 22-HERS,MEC14-(23 or 24)-HERS CF311-MECH-20-HEIS MECH 2Z HERS,MECH-(23 or 24)-HERS= Installer Requiirement-.Duct leakage:E 6%,Fan Efficacy(58wjCFM),Air Flow>_350 CFMj)vn(or5tandards Table 150.G-Cl D altemafive) ©3.All Naw Ducts with Replacement 1 Required Compliance Doraiments to bra left on site far Final: Includes replacing orinstallingA New CESRALT-f}Z-E Ducszand one or more of the following- CRR MECH-01 iviEQ-I-203 HER!5,MFCH423 or 24)-HERS ' I Candenszr Unit,Evaporator Coil,Furnace CFBIFWECH2O-HERS,MECH-(73 or Z4)-HERS Installer Requirement:Duct lealage<69k Air Flow>350 CPM/ton(orStandards Table 150.0-C f D all ernatiue) 1� i empted from duct leakage tesdng I existing duct systems are constructed,insulated or sealed with asbestos. ❑4,idew Ducting over 40 fest Required Compliance Documents to be left on site for FnaL• l Adding or replacingducts:in unconditsoned [FIR:ALi-0 E a � CFLR:MECH 210-HERS I space butlers u�an All ldevirDucsZ i CF3R:MECH 2P-HERS a s Installer Requimed to,.Duct leakage(<�S%or,_IA oto outside,orseal all acces!Zle•leaks) i0 Exempted from duct leakage testing Iewistingductsystamsareconstructeri insulated-orsealedwiihasbestos. 'All new ducl5ng R-8 required when morethan 40 ft installed and R-5 when less than x 0 ft installed_ibis includes in wails,betiueen floors eta ) 2A New Duct system is when the ductsystem is constructed of at least 75 percent new duct material,and up to ZS peccant may consist of,reused 3 i pares from the dwelling unit's existing duct system(e g.,registers,grilles,Boots,air handler,plenums,duct material- -5(i"thick insulation)fbr linesets 1=and less. R 75(15'thick insulation)for linesets over Y_inch. iViostm%vAll require Suction lineDiameter with insulation as tha iolioiAAng 15-2T-21.25 3T-23f-'-,35to 4T 2%-,ST-91.- contractor T-e.Contractor(Docurnenta-don Author'slResponsillle Designer's Declaration Statement) I certify the following under penalty of gerlucY,underthe laws ofthe State of California; 1_ The information provided on this Certificate of Complianceis true and correct. 2. ['am eligible under Division 3 ofthe Califomia Business and Professions Code to accept responsibilityforMe information on this document 3. That the energy factures and performance specifications ftirthe design identified on this Certificate of Compliance confonn to the requirements of Title 24,Parts land 6 ofthe California Code of Regulations(CCR)- 4. T hatthe energy features and perormance specifications,materials,components,and manufactured devices forthebifilding design or system design identified on this Certificate of Compliance conform to he requirements of Title 24,Part l and Part 6 ofthe CCR- S. The building design features or system design futures identified on this Certificate of Compliance are consistentitith the information 4 provided on other applicable compliance documents,,worksheets,cakula#tons,plans and specifications submitted to the enforcement agency for approval with this building perm-it application. Respansiole,DesipnerName: ResPaasibleoesigner5y-mature: - - ➢ate5igned: incense: . -. vi ' v �/v ew /b /ar"136 Canaany: } Address city/stm/DP, Phone: Uo f ct bU T -It2 i �� l` l=e j�r�- �ii'i'1r3 A S- P, - 8 For assistance or question gardingthe Energy Standards,contact the Energy Hotline at:3-800-772-330o F1 LIL SMOKE / CARBON MONOXIDE ALARMS � � � 1'G OWNER CERTIFICATE OF COMPLIANCE COMMUN"DEVELOPMENT,DEPARTMENT BUILDING DIVISION C1JPERTI40 1,0300 TORRE AVENUE m CUPERTINO,CA 95014-3255 (408)777-3228 o FAX(408)777-3333 building(aD_cupertino.org Permit No. Address 13 Park [ (Y #of Alarms Smoke• `1' Carbon Monoxide: t PERMIT CA1VN6T SE FINALED A_TD COMPLETED IINTII,THIS CERTIFIOATE AS" ItET1 1ET TO E BT1LD�G El PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the"valuation of additions, alterations,or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon ;Monoxide Alarms be installed in the following locations: _ AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings.which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling units with no commercial power supply, alarm(s)may be solely battery operated. In-existing dwelling units, alarms,are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl .space.Refer to CRC Section R31&and CSC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been installed in accordance with the,manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Lt_i _yo Si nature .........................Date: Contractor Name: Cinature......................... .. ......... ... c# Date: ..1....:..f.& Smoke and CO form.doe revised 03118114 4� 1 6 WATER-CONSERVING PLUMBING FIXTURES q OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUfiTiIIQ 10300 TORRE AVENUE CUPERTIN,O, CA 95014-3255 (408)777-3228•FAX(408)777-3333;• buildinaP-cupertino.org Owner Name � l Anq-� 0��1� �fl�� Permit No Address i Park , vi tia c t V - 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 2, 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures:isnot technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. El The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. K No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? El No My real property is built and available for use or occupancy after January, 1 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. L4 Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: I My properly is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014,building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or nnprovements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). 1,as the owner or owner's agent of this property,certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 110 1.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water-conseiving plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: Date: Upon completing and signing this Certificate,please retuf W it to the Building Division in order to final your building permit. SE40 7 2015.doe revised 08126/15 f ffOn-Compliant Water-Conserving Plumbing Fixture I Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Mater Usage/Flow Rate Water Usage 2013 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch.4 /blow bate 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 S!eagle-Family Multi-Family Commercial Mater Closets :Gallon ed 1.6 Residential Residential .(ToiletsSingle flush toilets: 1.28 gallons/flush slflush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, Urinals avera e flush volume of two reduced flushes and one full flush Exceed 1.0 Gallons/flush 0.5 gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of I gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower,the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi,or the shower shall be designed to allow onlyone shower outlet to be in operation at a time. Faucets— Exceed 2.2�gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi,and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,itis not required to be upgraded. SB407 2015:doc revised 08/26/15